Ask-A-Nurse: |
| Challenging the NCLEX Hello. I'm a foreign medical graduate, licensed in another country, US Citizen, interested in pursuing a career in nursing. I've heard that you can "challenge" the NCLEX, meaning that you can take it and get licensed without any formal nursing education (bachelors, associate degree). Is there any truth to this? Thank you for your time.
- Marissa
Answer:
Great question! Can a United States citizen with a foreign non-nursing degree (in this case, an MD) challenge the NCLEX without a formal education in nursing specifically? The answer depends largely on where you wish to practice, as each state board of nursing has its own NCLEX eligibility guidelines.
Most state boards of nursing require candidates for NCLEX-RN (registered nurse) licensure by examination to have a CGFNS Certificate. CGFNS certification is designed specifically for first-level general nurses only (i.e., those applicants who are already practicing registered nurses in another country and who received a formal nursing education outside of the United States). CGFNS certification entails a thorough credentials review of foreign education, licensure and registration, a qualifying exam and, in some cases, the TOEFL exam for English proficiency. Therefore, it is not likely that a foreign-educated MD would be able to take the NCLEX-RN to obtain licensure as a registered nurse.
You may, however, be eligible for NCLEX-PN (practical nurse) licensure by examination. If the state you wish to practice in allows it, you will need to utilize the CGFNS Credentials Evaluation Service. The CES evaluates the educational and professional credentials of a variety of healthcare professionals. The CES will review your credentials and provide a summary report to your designated state board of nursing. The state board of nursing will then make a decision regarding your eligibility to sit the NCLEX-PN and become licensed as a practical nurse.
For more information on the Credentials Review Service, visit the CGFNS website. To find out if your state utilizes the CES for LPN licensure consideration, contact your state board of nursing. Good luck!
Stephanie Thibeault, The Student Nurse Forum
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| CNA Recertification I was a CNA in a nursing home Kansas a little over 2 years ago. Now I am working with handicapped adults. I would like to get back in to being a CNA and was wondering how I could do that with out having to go through classes again. Please let me know as soon as you can. Thank you!
 Stephanie Answer:
I checked with the Kansas Department of Health and Environment, which awards certification for nurse aides and maintains the state registry. According to Federal regulation, a nurse aide who has not performed nursing or nursing-related services (via verified employment) for a period of 24 consecutive months must be removed from the state nurse aide registry. As such, you are currently ineligible for employment as a CNA.
You can be returned to eligible status without taking another CNA course, however. A potential employer may elect to perform a skills competency check using the HOC Skills Competency Checklist for Employment Verification. Using this method, a registered nurse at the facility you wish to work for will need to evaluate your performance on each task on the checklist. If you complete all of the tasks in a satisfactory manner, the RN will sign and date the form, then send it to the HOC to update your eligibility status. At that point, you will be eligible for employment again as a Certified Nurse Aide. Best wishes to you as you return to the CNA field!
Stephanie Thibeault, The Student Nurse Forum
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| Nursing School Interview I am scheduled to have a nursing school interview later this month and I'm a little nervous. What can I do to prepare? What should I expect during the interview?
- Dana
Answer:
It's understandable that you feel nervous about your interview. The good news is, there are things you can do to prepare that will calm your worries and boost your confidence:
1. Review typical questions that may be asked of you during the interview and practice answering them. Mentally rehearsing how you would like to respond will help you feel more prepared and positive on the day of the actual interview.
2. Make a list of questions to ask your interviewer. When you researched the nursing program prior to applying, were there any areas you would have liked to have more clarification on? The interview is your opportunity to ask, and it also shows your interest in the program.
3. Prepare an extra copy of your resume, transcript and application. Bring these with you to the interview in case you need to refer to them.
4. Plan out what you will wear. First impressions do count, and you will want to look polished and professional. Additionally, looking your best will help you feel more confident.
Finally, get a good night's sleep before the interview, and eat a healthy breakfast. You want to be at your best on interview day.
During the interview, you can expect to the interviewer to go over program information with you, sometimes in conjunction with a tour of the facilities. The interviewer will have a list of questions to ask you, and he or she may take notes while you respond. Typical questions include:
* What qualities and characteristics make a good nurse?
* What qualities can you bring to the nursing profession?
* Why did you decide to go into nursing (or, why do you want to be a nurse)?
* What do you consider to be your strengths?
* If there were one thing you could change about yourself, what would it be?
* What are your career goals?
You may also be asked about your volunteer experiences, extra curricular activities and healthcare experience. Don't be afraid to talk about your accomplishments.
The best advice I can give you is to be yourself during the interview. Remember to be positive, smile, make eye contact and - most important of all - relax! You will do just fine!
Stephanie Thibeault, The Student Nurse Forum
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| Lazy Classmate I have a good friend in my class who is making me crazy! She never does her work, and always hits up the rest of us for answers to homework questions right before class. Instead of taking her own notes, she asks to "borrow" ours. I really like her as a friend, but why should she get good grades without putting in the time and effort my classmates and I do? Grrr!
NinaAnswer:
There will always be at least one person in class looking for a free ride. I understand your exasperation. You work hard for your good grades, and it is not fair that a student who does not put in the effort is being equally rewarded. In fact, it is amazing that a student who is not doing her work is getting high marks in nursing school, which leads me to wonder two things:
1. Why do you continue to share your answers and notes with her, perpetuating the situation?
2. How does this affect your education?
If her persistent requests for homework answers and notes are leaving you frustrated and angry, why not say no? Continuing to enable her is not in anyone's best interests. It can be hard to confront someone who you are close to, but you need to set your limits in this case and be assertive. Explain to her that you value her friendship and want to be supportive, but she will need to do her own work.
My second question for you was how does this situation affect your education? In truth, it should not. You are in nursing school to learn how to be the best nurse you can be. You put significant time and effort into your studies not only to get good grades, but because you understand you need to know all the information presented to you. Once you graduate, it will be your license, your career, and your patients' lives on the line if you have dropped the ball. Have you learned all the material? Have you spent enough time on your studies? Have you done all your work? If so, then you are doing exactly what you need to do to meet your goals, and you should be proud of yourself. Your friend's poor study skills will catch up with her - hopefully sooner rather than later - but the person you need to be concerned with most is you.
My point here is to help you steer clear of toxic emotions that may end up affecting your education. Set boundaries with your friend, and then let go of any negative emotions you have been holding onto. Channel your energy back into your own studies so you can get the best education for your money. You are a good student and you will make a great nurse. Don't let your friend's actions distract you from your true goal - to learn to be the best nurse you can be. Keep up the good work!
Stephanie Thibeault, The Student Nurse Forum
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| Medical Surgical Specialization? Is there such a thing as medical-surgical specialization? If so, how do you get an application for the certification test?
- Josh
Answer:
Yes, there is such a thing as medical-surgical specialization in nursing. Sometimes referred to as the forgotten specialty, medical-surgical nursing is a challenging, fast-paced field filled with variety - there is just no telling what each shift will bring. It is because of this variety that many new grads are counseled to get at least a year's experience on a med-surg unit - there is no better place to hone your skills and get experience with a wide variety of diseases, conditions and treatments. Medical-surgical nurses, with their vast knowledge and skills-base, are the unsung heroes of the hospital setting. Nurseweek has a great article about medical-surgical nursing called A Walk on the Wild Side, which will give you further insight into this area of practice.
In this vital niche, certification can be earned as a Clinical Specialist in Medical Surgical Nursing. The American Nurses Credentialing Center (ANCC) determines eligibility guidelines, administers the national examination and awards certification.
Basic eligibility requirements for certification include:
 * a master's degree in nursing with medical-surgical concentration;* 12 months' medical-surgical practice following completion of your master's degree; * Currently providing direct patient care in a medical-surgical environment for a minimum of 4 hours a week or more; and* A cumulative total of 800 hours or more of direct patient care within the last 24 monthsMore information and the application to sit the certification exam can be found on the ANCC website.
Stephanie Thibeault, The Student Nurse Forum
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| Depressed About the NCLEX I took the NCLEX exam on 11/27 and I am in a stupor over my exam questions. The test I took was not representative of what I learned in my nursing program. I could not have passed unless by fluke. Half of the time, I felt like I was guessing. I am very depressed about this test.
- Karen
Answer:
Don't give up on yourself yet! The NCLEX was designed so that everyone who takes it will get exactly 50% of the questions wrong and 50% of the questions right. It works kind of like this:
If you get question #1 right, the computer says to itself, "That one was too easy for her...let's give her something really hard."
You get question #2 and it's way over your head. You have no idea what to choose and get it wrong. The computer says, "Okay, that was *too* hard," and it gives you another question that is easier.
It goes back and forth like that, throwing out questions covering all the test plan areas, easier and harder, back and forth, until it can narrow down and reasonably figure out what your competence level is on the continuum. If your competence level is above a
certain mark, you pass. If it is below, you do not.
So, basically, everyone comes out of the exam feeling certain that they failed, because they know they got a lot of questions wrong (the truth is, everyone will get exactly 50% wrong). Passing is not based on how many you answered correctly then, since everyone answers 50% correctly. Passing is based on the challenge level of questions you answered correctly.
I know you are feeling badly about the exam, but I think there is a very good chance you did pass. Hang in there, don't give up hope yet!
Stephanie Thibeault, The Student Nurse Forum
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| Correctional Nursing I am looking for information on correctional nursing. Are there any special educational requirements? What do corrections nurses do?
- Anne Marie
Answer:
Correctional nursing is a rapidly growing specialty in the profession that offers nurses a high level of autonomy and rewarding practice. Those who do well in correctional nursing have excellent critical thinking and assessment skills, are able to make decisions independently, and have solid interpersonal skills. They are also assertive, empathetic and able to provide care objectively when serving this special population.
What do correctional nurses do? On a given day, they may:
* Conduct physical and psychiatric assessments to new inmates, making appropriate recommendations
* Administer care and treatment to patients on the sick call list for a variety of acute illnesses and chronic conditions
* Respond to emergency situations
* Provide patient education to individuals who may have never had access to healthcare services in the past
The biggest misconception about corrections nursing is that it is unsafe. In truth, working in a correctional facility may be safer than working in the ER. What's more, this special niche in nursing offers a level of professional autonomy rarely seen in other areas.
Correctional nurses may complete a 2 or 4-year nursing degree program and become licensed as RNs, although there are also a good number of opportunities for LPNs working in this fascinating field. Correctional nurses may also seek to attain CCHP (Certified Correctional Health Professional) designation.
The CCHP exam is administered by the National Commission on Correctional Health Care (http://www.ncchc.org/). To qualify for the exam, an applicant must have worked in a correctional healthcare setting for 3 years and provide 3 letters of reference. The exam is open to physicians, nurses, and other healthcare providers working in corrections. The National Association of Correctional Nursing (http://www.correctionalnursing.org/) is also developing a credentialing program specific to nurses to promote quality standards and give professional recognition through certification.
Correctional nursing is a rewarding field offering challenging work and much professional satisfaction. Best wishes for a successful career in this field!
Stephanie Thibeault, The Student Nurse Forum
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| Medical Mnemonics I am having a hard time in a couple of my classes with memorization - there is just so much to learn! Do you have any tips to help me out?
LynnieAnswer:
For straight memorization, the best technique I have found is to create mnemonics. Mnemonics are aids for remembering information that is otherwise difficult to recall. It involves creating an easy-to-remember cryptogram, silly phrase or rhyme that will help you recall a larger or more complex body of information.
For example, if you need to memorize the order of the basic steps for resuscitation, you could use the mnemonic ABCDE (airway, breathing, circulation, drugs, environment). Another example is this rhyme for treating a person who has fainted: "If the face is red, raise the head. If the face is pale, raise the tail." Need to remember the order of those pesky cranial nerves? Try this goofy phrase: "On old Olympus' towering top, a fat, vain goblin viewed a hop." The first letter of each word in this jingle corresponds, in order, to the first letter of each cranial nerve (olfactory, optic, oculomotor, trochlear, trigeminal, abducens, facial, vestibulocochlear, glossopharyngeal, vagus, accessory and hypoglossal).
Mnemonics are fun, easy to remember, and best of all - they've been used by students in medical schools for decades. Most likely, if you are having trouble with a particular topic, someone else did too and a handy mnemonic has already been created.
Visit the MedicalMnemonics.com (http://www.medicalmnemonics.com) for the most comprehensive database of medical mnemonics on the net - they've got a mnemonic for everything! You can search by keyword or just browse by category. Another great resource is MD4sure.com (http://www.md4sure.com). This site has mnemonics concerning the basic sciences, medical conditions, etiologies, signs and symptoms, diagnoses, and therapies that can easily be remembered. They also have a handy list of medical acronyms and shorthand.
Good luck with mnemonics and your studies, Lynnie!
Stephanie Thibeault, The Student Nurse Forum
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| Nurse Epidemiologist I am a nursing student and am thinking of becoming a nurse epidemiologist. After getting my RN, do I need further training? Where can a nurse epidemiologist find work? Any related information would be helpful. Thanks!
ElectraAnswer:
Epidemiology is a fascinating field that focuses on the population perspective of healthcare and disease prevention. Have you read any articles recently on antibiotic-resistant bacteria, outbreaks of Dengue Fever or anthrax cross-contamination? Chances are a nurse epidemiologist was on the case, working with other healthcare professionals and scientists on research, tracking and control measures.
Most nurse epidemiologists complete a Master's Degree in Public Health (MPH) and may also seek to acquire certification in infection control. Infection control certification requires current licensure as an RN and a minimum of two years' experience working in an infection control or epidemiology-related position (for more information, see the Certification Board of Infection Control and Epidemiology at http://www.cbic.org).
Nurse epidemiologists study the distribution and dynamics of disease in population groups, evaluate the efficacy of healthcare programs and conduct clinical research. They monitor hospital and community-acquired infections, watching for clusters, and advise on infection control procedures and protocols. They are employed by hospitals, healthcare organizations, public health departments and community health organizations.
The American Nurse ran a great article offering an insider's view of this clinical specialty. "On the Superbug Front," which chronicles Barbara Russell's 25-year career as a nurse epidemiologist, can be read online at: http://www.nursingworld.org/tan/99novdec/nursspec.htm
I hope this information helps as you plan for your education and career as a nurse epidemiologist - best wishes to you!
Stephanie Thibeault, The Student Nurse Forum
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| Pediatric Dosage Calculations Hello, I am really "stressed out over nursing school" because I am having problems with pharmacology dose calculation problems. I have the basic idea, but am having difficulty with pediatric dose calculations more so than other concepts. Do you have any information on videos that are available with step by step basic instructions. I really enjoy using ratio to proportion and it helps a lot with basic problems. Thanks, and have a beautiful day!
LisaAnswer:
I checked with the major nursing education publishers and the only video support materials I found for dosage calculations were designed for classroom instruction. Unfortunately, these materials are cost prohibitive for the average student (roughly $400 per module).
That said, I would imagine your nursing program has a library of support materials you can access for free. These materials typically include books, computer tutorials and videos you can use at your own pace to practice and perfect dosage calculations. Ask your instructor what support materials are available to help you succeed.
Another option is peer tutoring. If you are not already in a study group, join or form one. If there is someone in your class who seems to do well with dosage calculations, ask them for help. They may have a different way of explaining things that will make more sense to you.
Finally, there are some great online resources to help you with your dosage calculations:
Pharmacology Math Tutorial for Nurses
This online tutorial hosted by the Alamo Community College District covers common conversion factors and equivalencies, abbreviations, ratios and proportions, IV and titration, and pediatric pharmacology math. Once you have completed the tutorial, there are online quizzes you can take, with automatic grading.
Pediatric Drug Calculations
This tutorial from the University of Kansas Medical Center reviews pediatric dosage calculations and includes a practice quiz.
Drug Calculations for Nurses
Drug Calculations for Nurses is an excellent shareware program developed by Richard Lakeman. It generates drug calculation quiz questions relating to metric conversions, tablet dosages, fluid dosages, intravenous flow rates and intravenous simulations. Questions are randomly generated based on a database of drugs. Help and solutions are included, as well.
Stephanie Thibeault, The Student Nurse Forum
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| Cultural Background Information I am currently undergoing my clinical rotation in mental health nursing and would like to know why nurses need to know about a patient's cultural background? Thanks in advance and I look forward to hearing from you.
SabrinaAnswer:
This is an important question and I am glad you asked! As nurses, our job is to assess and care for the needs of our patients holistically. Human beings are multi-faceted. As such, a complex network of interdependent factors jointly form the conditions for health or disease. To be a truly effective practitioner, a nurse needs to plan care that complements and supports the whole patient. This includes an accounting of physical, mental, spiritual, emotional, social, ethnic and cultural influences that collectively impact health.
Understanding a patient's cultural background is important for several reasons:
It improves the communication process. This helps you better understand what the patient is trying to express, and allows you to frame your questions in a manner the patient will understand. For example, a person of Chinese heritage may not be comfortable asking for pain medications. If you are not aware of this cultural trait, your patient could end up suffering needlessly.An understanding of cultural beliefs about health may help you identify the most appropriate interventions. For example, an anemic patient who is a strict vegetarian will not be compliant with interventions aimed at increasing meat protein intake. More appropriate action would include patient education about the combinations of plant foods that together form complete proteins.Patient comfort, which contributes significantly to the restoration of health, can be more readily achieved if you are aware of the cultural practices to which the patient adheres. For example, many cultures practice family-sleeping, wherein children sleep in the same bed as their parents. The recovery of a child from this cultural background may be greatly enhanced by allowing parents to stay overnight at the hospital whenever practicable.The most important thing to remember is that all patients are unique individuals deserving of respect and non-judgmental, quality care. Understanding and respecting cultural differences is an important foundation of your nursing practice. For more information and case studies, I highly recommend the Transcultural Nursing Website at http://www.culturediversity.org.
I hope this information helps - good luck to you in your mental health rotation!
Stephanie Thibeault, The Student Nurse Forum
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| DNR Orders I need information on DNR orders - what can you tell me about them?
- Leslie
Answer:
A DNR is a do-not-resuscitate order. If a patient stops breathing or if their heart stops beating, the DNR tells medical professionals they are not to initiate emergency cardiopulmonary resuscitation. It is important to note that the DNR only relates to CPR and does not apply to any other types of treatment or procedures.
In an emergency situation, it is assumed that all individuals would want CPR performed as a life-saving measure. However, individuals with a serious or terminal illness may decide in advance that they do not wish to have emergency CPR. This is because in certain cases, CPR may leave the individual in a worse state than before the procedure was performed. If CPR only partially works, an individual may be left with brain damage or other negative effects that would seriously limit their future quality of life. A DNR is a decision to let nature take its course without heroic interventions.
From an ethical perspective, DNR orders are acceptable when CPR would have a higher physical cost than benefit. Typically, an individual must discuss their health and options with their physician before a DNR order can be entered. A DNR can also be entered in written form via a Living Will, providing that there are two witnesses present. Finally, a DNR can be issued by proxy if you have legally designated another individual to make decisions about your healthcare treatment.
The University of Washington's School of Medicine has an excellent online tutorial about DNR orders and bioethics, including several case studies (http://eduserv.hscer.washington.edu/bioethics/topics/dnr.html). Another great resource to review is the American Nurses Association's position statement on DNR orders, which includes recommendations for DNR decisions and implementation as it pertains to nursing practice (http://www.nursingworld.org/readroom/position/ethics/etdnr.htm).
As a nursing professional, it can be difficult to stand down when there is a DNR order in effect, but ethically, the patient's values and choices take priority. Each individual has the right to make personal decisions about their healthcare and we, as healthcare providers, are obligated to respect those decisions.
Stephanie Thibeault, The Student Nurse Forum
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| Online CEUs Can you tell me of websites that have online nursing courses with CEU capability? Courses related to Hospice/Pain Managment would be of greatest benefit. Thanks!
- Karen
Answer:
What a timely question! The Student Nurse Forum just partnered with CEUs4U.com to be able to offer CEUs to nurses. I checked the database of available online courses, and they have several addressing Pain Management (up to 7 contact hours per course).
For hospice and palliative care CEUs, I hunted up the following online providers:
Hospice (9 offerings!): NurseCEU.com
End-of-Life Issues: Nursing Spectrum
Hope this helps!
Stephanie Thibeault, The Student Nurse Forum
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| Care Plan I need information on a nursing care plan for a 4 year old child with reactive airway disease.
- Nichole
Answer:
The most comprehensive resource online for care plans is Careplans.com. They have a vast librabry of sample care plans categorized by problem statements, as well as a message forum. Another resource is the Carepl-l list archives. Use the search function on their website to find what you are looking for, rather than wading through months of posts. Hope this helps!
Stephanie Thibeault, The Student Nurse Forum
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| NCLEX-PN Eligibility I recently graduated from a foreign medical school with a preparatory degree in BS Biology. However, I haven't taken the licensing exam for foreign medical graduates yet. I plan to take the review first and while doing so, I would like to get a job as an LVN/LPN. Is there any examination that I can challenge so that I don't have to study for 1 year in becoming an LVN. Please email me back. Thanks.
- May
Answer:
Eligibility to sit the NCLEX-PN is dependent on several factors, one of which is clinical experience. While there are a few states that individually may allow you to challenge the exam without graduating from an accredited LPN program, you would need to provide documented proof of significant clinical experience in a healthcare setting.
I am not sure of the particulars of your background in healthcare, but I would suggest going straight to the horse's mouth. You can contact the folks at The National Council of State Boards of Nursing by calling 1-800-551-1912.
Stephanie Thibeault, The Student Nurse Forum
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| Loan Repayment Program I'm looking for a program in which a hospital pays for your degree in return for several years of working at that hospital. I know this program exists - I just can't find it! Please help!
- Hannah
Answer:
I don't know what state you live in, or where you plan to go to school...but here are a few programs I turned up by entering "nurse education loan repayment" in the Yahoo search engine:
The Nursing Education Loan Repayment Program will repay up to 60% of your student loans in exchange for a 2-year employment contract to work in an approved facility in a rural or urban community with an underserved population and a shortage of nursing professionals. National program.
This program is similar to the one above, but funded at the state level:
North Carolina Scholarship-Loan Program for Health, Science and Mathematics
Comparable programs are offered in New Hampshire and Colorado (see Scholarships page).
I think the type of program you were thinking of is like the one offered by the Mountain States Health Alliance (a large healthcare organization in northeastern Tennessee). They pay for your schooling in exchange for an agreement to work at one of their facilities after graduation for a set number of years.
Mountain States Health Alliance - Northeastern TN
Write me back and let me know where you are located and I will be happy to try to find a program in your area!
Stephanie Thibeault, The Student Nurse Forum
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| History of Anesthetics Hi, I was wondering if you were experienced in the field of Anesthetics at all. If you were and you had some pictures or a website or a person we could call then could you please e-mail me back. If not, I would still appreciate an e-mail saying you don't, so I dont worry about it. If you don't get this before May 7, 2001, then please don't contact me unless its to say that you don't have any resources I could use. By the way, this is for a History Day project.
- Charity
Answer:
Here are some websites with information on anesthetics for your History Day project. The Virtual Museum of Anesthesiology and the Anesthesia History Calendar (see links below) are fun websites with lots of information. Also, you may want to e-mail the American Association of Nurse Anesthetists for information - I am sure they would have some folks you could interview. I have included their weblink below, as well.
History of Nurse Anesthesia Practice
History of Anesthetics
Anesthesia History Calendar
Virtual Museum of Anesthesiology
Anesthetics in Field and General Hospitals Of the Confederate States of America During the Civil War 1861-1865
Good luck on your History Day project!
Stephanie Thibeault, The Student Nurse Forum
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| Doctor Relations I'd like some pointers for getting along with my doctor. I have cleared HBV, but have active HCV for 29 years. My ALT and AST were high (2.5 x national average). Five years ago it dropped to just above normal and stayed there. I'm having HCV symptoms (joint aches, nauseous/vomiting, tenderness and swelling in my right upper abdomen, constantly tired and poor memory.) The GP says no testing for genotype, biopsy, viral load, etc. until I have two ALT and AST tests that are twice the national average.
I live in northern Canada. There are 3 GPs for 10,000 people. I’m the only HCV person in the area. I realize with the high patient load the doctor does not have the time to dedicate to research HCV for just one patient. The closest specialist is a $1,200 plane ride away and I have to be referred by my GP; he’s not willing to refer me until I get the two high tests. Even if he refers me, it may be years until my name comes to the top of the list. I’ve been on a list for almost three years to see a neurologist and this length of time wait is normal here. Any suggestions on how to work with my doctor to get the best medical care possible? Any suggestions on getting the lab personnel to wear rubber gloves when they take blood?
Thanks, Debbie
Answer:
I am so sorry to hear of your frustrations trying to work within the healthcare system to get the tests and treatments you need. Three GPs for 10,000 patients?? I am at a loss for words - but my heart goes out to you. Don't be afraid to be your own advocate - you deserve quality care and respectful consideration.
This forum was designed to answer questions nursing students have related to education and nursing practice. I am not comfortable with, nor qualified to give out medical advice regarding your condition. HOWEVER, I do have a great resource for you and some advice from our panelists regarding the doctor-patient relationship and protective gloves.
I came across the following gem of a website in my research. It was developed by a Canadian HCV sufferer and includes her personal story of navigating the system, fellow heppers' stories, medical resources, e-mail lists, support groups, Hep C links and alternatives.
Read on for some advice and encouragement from the nursing experts panel here at The Student Nurse Forum. I wish you all the best Debbie - please let us know how things go.
Stephanie Thibeault, The Student Nurse Forum
From Joanne Yastik, RN:
I spoke with several Canadian nurses where I work. They both indicate that the Canadian health care system is a tricky one. They felt you could possibly change doctprs, opting for one who would make the appropriate referrals, but again, it could take years for the specialty care - no one gets into a specialist without a referral from a GP. They suggested perhaps going to Toronto where there were more doctors. Also, the question about drawing blood with no gloves - universal precautions are in effect in Canada, so perhaps it was the particular lab. You should request (for your protection as well) the use of gloves as it is a standard of care.
Joanne Yastik, RN
Hi Debbie, The following is written assuming that you do NOT want to move to an area where you can more easily access the proper healthcare facilities and professionals. I will emphasize that if your health is a concern for you, you should NOT be satisfied with a three year wait to see a specialist!!!!!!!!! Wow! The doctors must have a tremendous load up there, eh? 10,000 patients! I have a feeling that you should keep a notebook or a dairy on your interactions with your doctor, your lab results, your signs and symptoms, changes in your health and emotions, etc. Remember to add dates and times. That way, when you speak with your doctor (who may or may not remember you) you have tangible evidence to show him/her about how your health has been and how your appointments have been going. They may not have the time to read all of your chart as they should. Feel free to jot down some latest information and research on your illness. Be prepared. Refer the staff to articles that will educate them about HCV so that they can protect themselves by using universal precautions (rubber gloves, etc.) when they treat you. Take care,
Sally Villasenor, BA, BSN, RN, RP
The Canadians have a national health insurance program (NHIP), the focus of which is to be cost effective and provide quality care. They believe this can be achieved through prevention and health promotive activities. Consumers (clients), as they are called, are encouraged to participate in their care and collaborate with pprofessionals and non professionals. The health benefits cover a broad spectrum of care except elective surgery. To successfully receive the benefits of this program, the consumers of Canada should focus on prevention care, i.e. routine checkups that are prescibed, and actively speak with health care providers about ways that he or she can achieve the optimal level of health. However, if after speaking with her health provider, she feels her concern are not completely satisfied, I think she needs to go to the person above the health provider for a better response. The Canadian health system NHIP is operated by each provincial government. Contact the administrator in your area to discuss your concerns.
Patricia Bennett, RN, MS, Assistant Professor
Molloy College , Rockville Centre, NY
Health Information, Tutorial Services, Career/Life Consulting Services
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| Reality Shock This is my last semester of nursing school and I'm doing a presentation on Reality Shock for New Nurses.I am having some difficulty finding current information about this topic. I would appreciate any information about REALITY SHOCK. Thank you!
- Emily
Answer:
I found three solid resources for you to evaluate as you develop your presentation:
WWW.NewGradProgram.Net
This is a web site designed to provide resource information on developing a nursing preceptorship program, with special focus on new grads or nurses returning to the work field, within an acute care facility. For your purposes, check out the great section on the three phases of reality shock and how to work through them.
Workplace Advocacy As a Transition Tool
This page was desinged to help the energetic "new nurses" who are exchanging the comfort of the school setting for the reality of the work world. Developer Carol A. Tingle, MSN, RN says, "You have heard the term 'reality shock;' workplace advocacy strategies could help you experience 'static electricity' rather than 'electrocution."
Shock of the New
This article from the Nursing Times focuses on reality shock for new grads. "The euphoria of qualifying as a nurse and getting your registration can be quickly followed by anxiety, trauma and fear as the struggle begins to make the transition from student to staff nurse. Nurses who have made the move often describe feelings of overwhelming shock when faced with the reality of accountability and responsibility."
I hope these resources are useful - I would love to read your presentation when you have it finished! Best wishes...
Stephanie Thibeault, The Student Nurse Forum
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| Cost vs. Compliance I am having trouble finding articles on the effects of the cost of medication and the nurse's ability to assist in patient compliance. Do you know of any websites with articles dealing with this topic? Especially how it affects patients and nurses in urban communities where healthcare financial issues are important. Thanks!
- Anne-Marie
Answer:
Great question! Medication non-compliance, the failure to take drugs on time in the dosages prescribed, is as dangerous and costly as many illnesses. Studies have shown than non-compliance causes 125,000 deaths annually in the US, leads to 10 to 25 percent of hospital and nursing home admissions, and is becoming an international epidemic. It is, in the words of The New York Times, the world’s "other drug problem."
I had a dickens of a time finding quality articles for you that specifically addressed your needs. I did find the following two resources - the first is probably more useful than the second:
Examination of Economic Barriers Influencing Pain Management and Their Effects on Rural Families Experiencing Cancer: A Pilot Study
Canopy System Case Study
I hope these are helpful - best wishes as you continue your studies!
Stephanie Thibeault, The Student Nurse Forum
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| States Requiring BSN? Are there any states that do not recognize a two-year associate degree in nursing? I was informed that North Dakota was one, is this true, and are there others?
- Melissa
Answer:
I did some checking, and North Dakota does require a bachelor's degree in nursing in order to be eligible to sit the NCLEX-RN. According to the North Dakota Board of Nursing, "successful completion of the baccalaureate degree nursing program is one of the requirements for admission to the registered nurse licensing examination." Additionally, they note that to sit for the practical nurse (LPN) exam, a student is required to have successfully completed an associate's degree nursing program.
This is the first state I am aware of that requires a BSN for RN licensure. There have been efforts for some time now to raise the education requirements nationally to the BSN level, however these changes will be made on a state-by-state basis if they occur. Previously licensed RNs in affected states would be grandfathered in.
I have been unable to locate a comprehensive listing that includes individual state licensing requirements. I imagine this is because state laws change frequently, so such a list would be difficult to keep current. Your best bet is to check directly with the State Boards of Nursing where you intend to practice, to make sure you will meet their prerequisites to sit the NCLEX-RN. A contact list can be found on the National Council of State Boards of Nursing website.
Good luck to you and much success as you pursue your education!
Stephanie Thibeault, The Student Nurse Forum
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| Unfunded Patients I am currently enrolled in the LVN program at Austin Commuity College and I have to write an ethics paper this semester. My topic is the discrepancy of care between funded and unfunded patients. My question is: where are some web sites to look up info. on this subject?
- David
Answer:
Here are a few good articles to get you started - and there are plenty more where that came from! I typed "nursing ethics uninsured patients" into the search box on Yahoo, if you want to review more material or refine your search.
Fighting Against the Evils of For-Profit Health Care: The Patients’ "Bill of Rights"
Who Gets Seen? (Ethics Connection)
Business Practices and Health Care Ethics
Mission and Markets in Health Care: Protecting Essential Community Providers for the Poor
Hope this information helps!
Stephanie Thibeault, The Student Nurse Forum
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| Bad First Exam I just got enrolled in nursing school for the 2-year RN program. I took my first test and performed poorly. I know I didn't study enough. Will I be able to bounce back in the next 7 exams?
- Balwyn
Answer:
I think part of your answer lies in your original question - you said you know you didn't study enough. It can be difficult at the beginning of school to know what to expect on the exams - how hard will they be? How much of the material will you actually be tested on? How much study time is required to perform successfully on the exams?
The answers to these questions depend in large part on your instructors and their particular testing styles. Until you have had that first exam, it's hard to know what to expect and how to prepare.
Can you bounce back? Absolutely! I don't think there's a nursing student out there who hasn't bombed one of their first exams. Although I know you are disappointed, use this test as a learning experience. Look at the kinds of questions you were asked. Was it primarily short-answer and essay questions? If so, concentrate on having an in-depth understanding of the core concepts. These kinds of questions are usually designed to gauge your critical thinking skills and ability to apply the knowledge to different situations. Were the questions multiple choice, fill-in-the-blank and/or true/false? If this was the case, you will need to beef up on facts and concentrate on memorizing definitions, formulas, rules, etc.
Another thing that will help you prepare for the next exam is your course syllabus. It will list the very information you are required to learn in the class. Use this as a study guide for each section. You can do this by turning course objectives into questions (ex: "student will be able to demonstrate understanding of cell theory" becomes "What is cell theory?").
For more great study tips and time savers from nurses who have been there, go to More Tips From The Pros.
One more thing to hopefully make you feel better...if you have 7 more exams to go, you have plenty of time to bring your grade up. For example, if you got 60% on this exam, and are able to hit 85% on the next 7, your final grade would be 82% (which is usually a B). Even an A is still possible - so there is hope!
Balwyn, don't give up, and don't be too hard on yourself - trust me when I say that this has happened to everyone at one point. Next time, you will know better what to expect, will be better prepared, and you will be successful! Best wishes as you continue your studies - let us know how you do!
Stephanie Thibeault, The Student Nurse Forum
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| L&D LPN? My question is: Is it possible for an LPN to work in Labor and Delivery?
Christy
Answer:
I have found numerous employment listings for LPNs to work in L&D, but have been unable to locate any source material outside of classified ads to back this up. I am assuming an LPN can work in L&D, just as a tech or CNA can work in L&D - it is the scope of practice that is the issue. Regulations will vary from state to state - check with your state board of nursing. Read on for advice and insight from our nursing panel members...
Stephanie Thibeault, The Student Nurse Forum
Our responses to this question come from Patricia Bennett, RN, MS and Sally Villasenor, BA, BSN, RN, RP:
In response to the nursing student wanting to know if LPNs could work in L&D, under New York state law, the only limitation is that LPNs cannot do an initial assessment. I have seen LPNs in L&D - their practice is comparable to the RN. However, the RN is reponsible for new admissions, as well making a
nursing care plan.
Patricia Bennett, RN, MS, Assistant Professor
Molloy College , Rockville Centre, NY
Health Information, Tutorial Services, Career/Life Consulting Services
COULD an LPN work in L&D? I guess that depends on her level of experience and comfort with the role. I am sure an LPN is just as trainable as a BSN or ADN, however she may require some additional background education. Also, finding a posted job in that area may be more difficult. LPNs normally can not start IV's and give IV/IVP medications. I am not exactly sure what other limitations they may have. My opinion is: WE set limits for OURSELVES. Any determined person can get a job doing anything they love!
Sally Villasenor, BA, BSN, RN, RP
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